Violence against health personnel in emergency rooms
Violencia contra personal de salud en salas de emergencias
Raúl Comas-Rodríguez
ua.raulcomas@uniandes.edu.ec
Universidad Regional Autónoma de Los Andes. UNIANDES,
Ambato – Ecuador
https://orcid.org/0000-0003-1353-2279
ABSTRACT
The
objective of this study was to analyze violence against health personnel in
emergency rooms. We worked with a
descriptive documentary research, in a bibliographic population of 15
scientific articles, located in Scielo, PubMed, Scopus. The studies analyzed
show a high rate of violence against health personnel in emergency areas, which
is developed by patients' relatives, and another within the institution as part
of workplace harassment. In both cases, the weakness or non-existence of
strategies for effective prevention against violence is exposed, highlighting
the need for community educational programs to sensitize hospital users about
the importance of treating health personnel without violence. This implies a
great weakness on the part of hospital management.
Descriptors: work
environment; violence; social
problems. (Source: UNESCO Thesaurus).
RESUMEN
Se tiene por objetivo analizar la violencia contra personal
de salud en salas de emergencias. Se
trabajó con una investigación de tipo descriptiva documental, en una población
bibliográfica de 15 articulos científicos, ubicados en Scielo, PubMed, Scopus. Los
estudios analizados evidencian una alta tasa de violencia contra el personal
sanitario en las áreas de emergencia, la cual se desarrolla desde los
familiares de los pacientes, y otra en el interior de la institución como parte
de acoso laboral. En ambos casos, se expone la debilidad o inexistencia de
estrategias que permitan ejecutar una efectiva prevención contra la violencia,
destacándose la necesidad de contar con programas educativos comunitarios con
la intención de sensibilizar a los usuarios del hospital, sobre la importancia
de tratar sin violencia al personal de salud. Esto implica una gran debilidad
por parte de la gerencia de las instituciones hospitalarias.
Descriptores: ambiente de trabajo; violencia; problema
social. (Fuente: Tesauro UNESCO).
Review articles
section
INTRODUCTION
Workers or a group of workers may receive
psychological violence from their colleagues or superiors during a prolonged
period of time at work, producing mistrust of themselves and their professional
capacities (Ochoa-Díaz, et al. 2021), therefore, violence at work could trigger
health violations in those affected (Olivera-Carhuaz,
2020).
Therefore, workplace violence could be part of
the health professional's work, as it could be confused by the perpetrators, to
violence as a right, especially when 6 out of 10 people surveyed in the study
(Barredo-Ibáñez, 2017), did not perceive verbal or psychological aggression
against other people as violence in their daily lives, which implies that
workplace violence could be generated as part of an interpersonal relationship
where violence is not fully valued, generating inconveniences in the mental
health of those involved.
Among the consequences of workplace violence,
the most notable are those related to the physical and mental health of the
affected person, in addition to suffering from depressive symptoms,
post-traumatic stress disorder (PTSD) and occupational stress (Palma, et al.
2018), (De-Miguel-Barrado, & Prieto-Ballester,
2016), being important to note that the presence of anxiety (Bautista-Cerecedo,
et al. 2011).
Based on the above, the objective is to
analyze violence against health personnel in emergency rooms.
METHOD
We worked with a descriptive documentary type
of research, with the intention of processing information related to the
objective of the research, in a bibliographic population of 15 scientific
articles, located in Scielo, PubMed, Scopus, to which we applied content
analysis and analytical-synthetic method with the intention of forming a
theoretical corpus as a result of the research.
ANALYSIS
OF THE RESULTS
The
study by (Cannavò, et al. 2019), who highlight
the spread of workplace violence by patients and/or their relatives against
emergency health professionals, related to gender, professional qualification,
role in the organization and workplace, is presented. Almost all male and
female health workers reported that they had suffered the effects on lifestyle,
work habits, and well-being and health following workplace violence. The
precipitating factors for violent incidents identified by healthcare
professionals are consistent with the research literature. The commitment of
hospital administrators, ED managers, and hospital security is necessary to
facilitate improvement and ensure a safer workplace for ED healthcare workers.
Likewise,
(Cannavò, et al. 2017), points out that ED
healthcare workers are at risk for workplace violence and should receive
specific training and support in the management of violent situations focused
on early identification, communication strategies and de-escalation techniques.
The two previous studies highlight the need for health institutions in
emergency areas to have communication and education channels to prevent
violence to their workers by hospital users. On the other hand; the experience
of violence of emergency physicians is related to personal characteristics such
as age and level of experience, and to hospital and emergency characteristics,
such as high rates of patient admission, currently, no measure adopted to
reduce this violence has proven to be effective (Bayram, et al. 217),
this study makes evident the weakness of the strategies for preventing violence
against medical personnel in emergency areas.
Accordingly;
a total of one hundred and seventy-four physicians (85% of the target group)
have been investigated in one study. Many of the participants were between 24
and 59 years old, with a mean age of 36.8 ± 5.8 years. Most were married male
physicians working in the city hospital. There were significant associations
between emotional exhaustion and total violence (p=0.012) and verbal violence
(p=0.016); depersonalization and total violence (p=0.021) and verbal violence
(p=0.012); the results presented here indicated that there was a strong
relationship between exhaustion and violence experienced by physicians working
in emergency units. Violence in the emergency department has a substantial
effect on physicians' well-being (Erdur, et al.
2015).
Likewise,
violence against healthcare workers in the emergency department is an important
issue that cannot be ignored. There are multiple reasons, the key point in
addressing the problem is to deal with its specific causes, presenting the
figures that 59.7% of healthcare workers reported WPV. Verbal violence was the
most reported (58.2%), compared to physical violence (15.7%). The most reported
reasons for violence were waiting time and failure to meet patient and family
expectations. Only 29.5% of health care workers who suffered verbal violence
and 23.8% of those who suffered physical violence reported it to hospital
authorities. About 75% of healthcare workers thought that workplace violence
was preventable, and about 60% said that hospital authorities had not taken any
action against the attacker (Abdellah, & Salama, 2017).
In consideration, (Çıkrıklar,
et al. 2016), posit that violence against emergency department employees
is a widespread problem. This situation has a strong negative effect on
employee satisfaction and job performance. To reduce the incidence of violence
in the emergency department, both patients and their families should be better
informed so that they have realistic expectations as emergency patients,
deterrent legal regulations should be implemented, and greater efforts should
be made to provide better services. Safety for emergency department staff.
These measures will reduce workplace violence and stress experienced by
emergency workers. We expect this to have a positive impact on the delivery of
emergency medical care services.
Regarding workplace bullying, resident physicians in
the study by (Schnapp, et al. 2016), highlight that the majority of
residents (66%, 78/119) reported experiencing at least one act of physical
violence during an ED shift. Almost all residents (97%, 115/119) experienced
verbal harassment, 78% (93/119) had experienced verbal threats, and 52%
(62/119) reported sexual harassment. Nearly a quarter of residents felt safe
"occasionally," "rarely," or "never" while
working. Patient-based factors most commonly cited as contributing to violence
included substance use and psychiatric illness. Therefore; the incidence of
violence and patient risk factors are similar to those previously found for
other ED staff. Understanding the prevalence of workplace violence, as well as
related systems, environmental and patient-based factors is essential for
future prevention efforts.
For the nursing population, the prevalence of
workplace violence was 65.8%; of this, 64.9% was verbal violence, and physical
violence and sexual harassment accounted for 11.8% and 3.9%, respectively. Frequent
workplace violence occurred mainly in the emergency and pediatric departments.
Respondents reported that patients' relatives were the main perpetrators in
tertiary and county hospitals. Workplace violence is prevalent in tertiary and
county hospitals in China; its occurrence is especially frequent in emergency
and pediatric departments, therefore, it is necessary
to address workplace violence by developing effective control strategies at the
individual, hospital, and national levels (Shi, et al. 2017).
CONCLUSION
The studies analyzed evidence a high rate of
violence against healthcare personnel in emergency areas, which develops from
patients' relatives, and another within the institution as part of workplace
bullying. In both cases, the weakness or non-existence of strategies for
effective prevention against violence is exposed, highlighting the need for
community educational programs to sensitize hospital users about the importance
of treating health personnel without violence. This implies a great weakness on
the part of the management of the hospital institutions, as well as the
management training during the training career of doctors and nurses, needing
to increase their competencies in soft skills in order to have the necessary
mechanisms of persuasion and negotiation as allies to minimize violence on the
part of hospital users.
FINANCING
Non-monetary
CONFLICT OF INTEREST
There is no conflict of interest with persons or institutions related to
the research.
ACKNOWLEDGMENTS
Universidad Regional Autónoma de Los Andes. UNIANDES, Ambato - Ecuador.
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